Wiki Modifier 57 - lumbar hemilaminectomy

[cristareyes]

Hello,

Is it right to add a modifier 57 to this case?

Patient had lumbar hemilaminectomy with microdiscectomy, foraminotomies scheduled on 3/7/16. Patient was sent home same day. Patient was rushed back to the ER on 3/8/16 due to pain in both legs. The doctor then discussed with the patient to have another surgery. The patient then made the discussion to have another surgery. The patient then underwent another surgery on 3/9/16 lumbar exploration and duraplasty.

Would you use modifier 57 for the ER visit on 3/8/16 and what E/M code would you use?

Thank you.

 

[JEYCPC]

In order to give E/M advice we would need to see the notes to determine level. Look at the CPT guidelines to determine the level. This link will help you with modifier 57 use:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/GloballSurgery-ICN907166.pdf

 

[TishCpc]

modifier 57

Since he was seen in the e/r I would amend a 78 if he was sent to the or. Emergent services should take precedence over any modifier, from my experience.